IIPP INFORMATION.. iii

SECTION 1:INTRODUCTION AND SCOPE.. 1

SECTION 2:RESPONSIBILITIES.. 2

Department Manager 2

Supervisors. 2

Employees. 2

Department SafetyCoordinator or Safety Liaison. 3

Department SafetyCommittees. 3

Environment, Health& Safety (EH&S) Injury Prevention Division. 4

Director ofEnvironment, Health and Safety. 4

SECTION 3:IDENTIFICATION AND EVALUATION OF WORKPLACE HAZARDS.. 5

Inspection ProgramOverview.. 5

Scheduled SafetyInspections. 5

Unscheduled SafetyInspections. 5

Reporting Hazards orUnsafe Work Practices. 6

SECTION 4: CORRECTING WORKPLACE HAZARDS.. 7

Hazard Correction. 7

Hazard CorrectionReport 7

SECTION 5:COMMUNICATING WORKPLACE HAZARDS.. 8

Supervisors. 8

Safety Committee. 8

Resources. 8

SECTION 6: INCIDENT,INJURY & ILLNESS REPORTING AND INVESTIGATIONS.. 11

Incident, Injury andIllness Reporting and Treatment 11

IncidentInvestigations. 12

SECTION 7:  TRAININGAND DOCUMENTATION.. 13

Safety Training. 13

Documentation. 13

Recordkeeping. 14

SECTION 8:COMPLIANCE.. 15

APPENDIX A: FORMSAND CHECKLISTS.. A-1

APPENDIX B: TRAININGGUIDES.. B-1

APPENDIX C: RESOURCES.. C-1

APPENDIX D:DEPARTMENTAL TRAINING RECORDS.. D-1

APPENDIX E:DEPARTMENTAL INSPECTION REPORTS.. E-1

THIS PAGEINTENTIONALLY LEFT BLANK.

EffectiveDate:  September2011

School:David Geffen School ofMedicine

Department:             Medicine

DepartmentHead:    AlanFogelman, MD  

Name

                                   Professor, Director of Medicine

Title

ResearchSafety Liaison:    Srinu Reddy PhD

                                                Name

                                                SReddy@mednet.ucla.edu

                                                E-mail

SafetyCoordinator:              Susan Hama

                                                Name

                                                SHama@mednet.ucla.edu

                                                E-mail

ResearchSafety Liaison:     GregHough

                                                Name

GHough@mednet.ucla.edu 

                                                E-mail

AdminSafety Liaison:          Courtney Bowden

                                                Name

                                                CBowden@mednet.ucla.edu

                                                E-mail

ClinicalSafety Liaison:        Dr. John Barstis

                                                Name 

jbarstis@mednet.ucla.edu

                                                E-mail

SafetyRelated Items:

Kept with Administrative Safety Coordinator

Locationof safety meeting minutes

Kept with Administrative Safety Coordinator

Locationof Employee Safety Recommendation Form

Kept with Administrative Safety Coordinatoror Lab Manual

Locationof training and other safety-related items

NicoleConner, x53073, nconner@mednet.ucla.edu

Personwho assists injured employees with appropriate paperwork

SafetyCommittee:

TheSafety Committee meets: Quarterly      

TheSafety Committee members are:

MemberName:          Dr. Srinu Reddy MD

Section/Sub-unit:       Research Unit / Cardiology

MemberName:          Greg Hough

Section/Sub-unit:       Research Unit / Admin

MemberName:          Courtney Bowden

Section/Sub-unit:       Administrative Unit

MemberName:          Dr. John Barstis

Section/Sub-unit:       Clinical Unit

MemberName:          Zhaoping Li

Section/Sub-unit:       Clinical Nutrition

MemberName:          Mirjam Schenk

Section/Sub-unit:       Dermatology

MemberName:          Osvaldo Rey

Section/Sub-unit:       Digestive Diseases

MemberName:          Tatyana Gurlo

Section/Sub-unit:       Endocrinology

MemberName:          Jonothan Wanagat

Section/Sub-unit:       Geriatrics

MemberName:          John Timmerman

Section/Sub-unit:       Hematology/Oncology

MemberName:          Otto Yang

Section/Sub-unit:       Infectious Diseases

MemberName:          Ning Li

Section/Sub-unit:       Nano Medicine

MemberName:          Alexander Pushkin

Section/Sub-unit:       Nephrology

MemberName:          Ella Nemeth

Section/Sub-unit:       Pulmonary

MemberName:          Ram Raj Singh

Section/Sub-unit:       Rheumatology

MemberName:          Steve Chorna

Section/Sub-unit:       Admin

MemberName:          Susan Hama

Section/Sub-unit:       Admin

Buildingsoccupied by this department: This section will assist you in ensuringthat all your staff members are trained on the appropriate Emergency Responseand Business Continuity Plans. (For off campus buildings, write the physicaladdress of the building. Do not include buildings used only for storage.)

1.         Buildingname or address:      Warren Hall

Unit within your department: Endocrinology,Clinical Nutrition, Pulmonary & Critical Care Medicine, Geriatrics,Nephrology, Digestive Diseases

Building Coordinator and phone no at thislocation: Anna Marie Acosta: x47521, aacosta@mednet.ucla.edu

2.         Buildingname or address:      Factor Building

Unit within your department: Endocrinology,Pulmonary & Critical Care Medicine,  Nano Medicine, Nephrology,Dermatology, Hematology-Oncology,

Building Coordinator and phone no at thislocation: Yanina Venegas: x68646, yvenegas@mednet.ucla.edu

3.         Buildingname or address:      Center for Health Sciences (CHS)

Unit within your department: Endocrinology,Pulmonary & Critical Care Medicine, Clinical Allergy & Immunology,Infectious Diseases, Cardiology, Dermatology, Digestive Diseases,Hematology-Oncology

           BuildingCoordinator and phone no at this location: Stephen Chorna, x50630, schorna@mednet.ucla.edu

4.         Buildingname or address:      Biomedical Sciences Research Building (BSRB)

Unit within your department: InfectiousDiseases, Dermatology, Hematology-Oncology

Building Coordinator and phone no at thislocation: Leon Kenyon, x64857, LKenyon@mednet.ucla.edu

5.         Buildingname or address:      MacDonald Research Laboratories (MRL)

Unit within your department: InfectiousDiseases, Digestive Diseases, Hematology-Oncology, Cardiology

Building Coordinator and phone no at thislocation: Leon Kenyon, x64857, LKenyon@mednet.ucla.edu

6.         Buildingname or address:      California NanoSystems Institute (CNSI)

            Unitwithin your department: Nano Medicine

Building Coordinator and phone no at thislocation: Mike Lozano, x49388, MLozano@cnsi.ucla.edu

7.         Buildingname or address:      Gonda Research Laboratories

            Unitwithin your department: Cardiology

Building Coordinator and phone no at thislocation: Leon Kenyon, x64857, LKenyon@mednet.ucla.edu

8.         Buildingname or address:      100 Medical Plaza

Building Coordinator and phone no at thislocation: Tony Michaelis x49822, tmichaelis@mednet.ucla.edu

9.         Buildingname or address:      2825 Santa Monica Blvd., Santa Monica

            Unitwithin your department: Hematology-Oncology

Building Coordinator and phone no at thislocation: Beverly Otayde x310-586-2082, botayde@mednet.ucla.edu or  DennisSlamon, 310-825-5193, dslamon@mednet.ucla.edu

10.       Buildingname or address: Hillblom Islet Research Center

            Unitwithin your department: Endocrinology,

Building Coordinator and phone no at thislocation: Tatyana Gurlo x 65851, tgurlo@mednet.ucla.edu or  Anna Marie Acosta: x47521, aacosta@mednet.ucla.edu

11.       Buildingname or address:      1033 Gayley Ave.

            Unitwithin your department: Nephrology, Endocrinology

Building Coordinator and phone no at thislocation: Dr. Suphamai Bunnapradist, 310-825-6836, bunnapradist@mednet.ucla.edu

12.       Buildingname or address:      10630 Santa Monica Blvd., Los Angeles

            Unitwithin your department: Nephrology,

Building Coordinator and phone no at thislocation: Dr. Anjay Rastogi, 310-954-2692, arastogi@mednet.ucla.edu

13.       Buildingname or address:      1399 S. Roxbury Dr.   # 100

            Unitwithin your department: CARE Center

Building Coordinator and phone no at thislocation: Dr. Ronald Mitsuyasu, 310-557-1891, rmitsuya@mednet.ucla.edu

14.       Buildingname or address:      200 Medical Plaza

Building Coordinator and phone no at thislocation: Tony Michaelis x49822, tmichaelis@mednet.ucla.edu

15.       Buildingname or address: 900 Weyburn Place # 14-171 Los Angeles, CA 90095  

Building Coordinator and phone no at thislocation: Tony Michaelis x49822, tmichaelis@mednet.ucla.edu

16.       Buildingname or address:      1245 16th Street, Santa Monica, CA 90404

Building Coordinator and phone no at thislocation: Lillian Martinez 310-582-6226, lmartinez@mednet.ucla.edu

17.       Buildingname or address:      2020 Santa Monica Blvd, Santa Monica, CA 90404

Building Coordinator and phone no at thislocation: Lillian Martinez 310-582-6226, lmartinez@mednet.ucla.edu

18.       Buildingname or address: 2336 Santa Monica, Blvd, Santa Monica, CA 90404

Unit within your department: Hematology-OncologyBuilding Coordinator and phone no at this location: Lisa Wilen310-633-8400, lwilen@mednet.ucla.edu.

19.       Buildingname or address:      625 S. Fair Oaks Ave., Suite 320, Pasadena, CA 91105

            Unitwithin your department: Hematology-Oncology Building

Building Coordinator and phone no at thislocation: Jessica Osorio 626-396-2990, josorio@mednet.ucla.edu

20.       Buildingname or address:      23929 McBean Parkway, Suite 215, Valencia, CA 91355

            Unitwithin your department: Hematology-Oncology Building

Building Coordinator and phone no at thislocation: Pam Schaffer 661-255-6213, pschaffer@mednet.ucla.edu

21.       Buildingname or address: 1250 La Venta Drive, Suite 202, Westlake Village, CA 91361   

            Unitwithin your department: Hematology-Oncology Building

Building Coordinator and phone no at thislocation: Amanda Hobson: 805-496-5270, ahobson@mednet.ucla.edu

22.       Buildingname or address:      2750 North Sycamore Drive, Suite 201, Simi Valley , CA 93065

            Unitwithin your department: Hematology-Oncology Building

Building Coordinator and phone no at thislocation: Amanda Hobson: 805-496-5270, ahobson@mednet.ucla.edu

23.       Buildingname or address:      924 Westwood Blvd. Los Angeles, CA 90024           

Unit within your department: DigestiveDiseases, Hematology-Oncology, GIM, Geriatrics

Building Coordinator and phone no at thislocation: Yanina Venegas: x68646, yvenegas@mednet.ucla.edu

24.       Buildingname or address: 2428 Santa Monica, Blvd., Suite 208, Santa Monica, CA 90404          

Unit within your department: East-WestMedicine

Building Coordinator and phone no at thislocation: Lillian Martinez 310-582-6226, lmartinez@mednet.ucla.edu

25.       Buildingname or address:      Peter Ueberroth (PVUB)       

Unit within your department: DigestiveDiseases, Hematology-Oncology, Geriatrics

Building Coordinator and phone no at thislocation: Adriana Centeno x47170, acenteno@mednet.ucla.edu

26.       Buildingname or address:      10940 Wilshire Tower

Unit within your department: Hematology-Oncology,Digestive Diseases, Geriatrics, General Internal Medicine

Building Coordinator and phone no at thislocation: Sue Ingham, x40808, singham@chr.ucla.edu

27.       Buildingname or address:      Rehab Center 1000 Bedford

            Unitwithin your department: Rheumatology

Building Coordinator and phone no at thislocation: Juan Vaquerano: x52572, jvaquerano@mednet.ucla.edu

28.       Buildingname or address: Brain Research Institute

            Unitwithin your department: Cardiology

Building Coordinator and phone no at thislocation: Leon Kenyon, x64857, LKenyon@mednet.ucla.edu

29.       Buildingname or address:      9911 W. Pico, Los Angeles, CA 90035

            Unitwithin your department: CARE Medicine

Building Coordinator and phone no at thislocation: Rebecca MacFarlane 310-557-1898, RMacFarlane@mednet.ucla.edu

30.       Buildingname or address:      Davita, 10630 Santa Monica Blvd, Los Angeles, CA 90025 

Building Coordinator and phone no at thislocation: Dr. Anjay Rastogi, 310-954-2692, arastogi@mednet.ucla.edu  

31.       Buildingname or address: 911 Broxton, Los Angeles, CA 90024

Unit within your department: GeneralInternal Medicine

Building Coordinator and phone no at thislocation: Norma Vaquerano: x42280, nvaquera@mednet.ucla.edu

32.       Buildingname or address:      VA - Sepulveda          

Building Coordinator and phone no at thislocation: Marianne Kimmerle: 818-895-9394, mkimmerle@mednet.ucla.edu

33.       Buildingname or address:      VA - Wadsworth         

Building Coordinator and phone no at thislocation: Jackie Pious Gaines: x20581, jpgaines@mednet.ucla.edu

34.       Buildingname or address:      330 South Garfield Ave., Suite 308. Alhambra, CA 91801

Unit within your department: Cardiology

Building Coordinator and phone no at thislocation: Teresa Sanchez x41844, tmsanchez@mednet.ucla.edu

35.       Buildingname or address:      100 Moody Court, Suite 110 & 200, Thousand Oaks,CA 91360

Unit within your department: Multi-Specialty

Building Coordinator and phone no at thislocation: Ann Sullivan or Anahit Khacheryan 805-418-3400, asullivan@mednet.ucla.edu or akhacheryan@mednet.ucla.edu

36.       Buildingname or address:      1250 La Venta Drive, Suite 105 & 200, WestlakeVillage, CA 91361

Unit within your department: Multi-Specialty

Building Coordinator and phone no at thislocation: Ann Sullivan or Anahit Khacheryan 805-494-6026, asullivan@mednet.ucla.edu or akhacheryan@mednet.ucla.edu

37.       Buildingname or address:      3445 Pacific Coast Highway, Suite 100, Torrance, CA90505

Unit within your department: Endocrinology 

Building Coordinator and phone no at thislocation: Lisa Gorski or April Stokes 310-784-4477, lgorski@mednet.ucla.edu or amstokes@mednet.ucla.edu

38.       Buildingname or address:      3701 Skypark Drive, Suite 200, Torrance, CA 90505

Unit within your department: Pulmonary& Critical Care

Building Coordinator and phone no at thislocation: Lisa Gorski  or Christine Melcher 310-784-4477, lgorski@mednet.ucla.edu or cmelcher@mednet.ucla.edu

39.       Buildingname or address:      23520-50 Hawthorne Blvd, Suite 180, Torrance, CA 90505 

Unit within your department: Pulmonary& Critical Care-Sleep Medicine

Building Coordinator and phone no at thislocation: Lisa Gorski  or Elizabeth Lewis 310-784-4477, lgorski@mednet.ucla.edu or ellewis@mednet.ucla.edu

40.       Buildingname or address:      4746 Barranca Parkway, Irvine, CA 92604  

Unit within your department: Hematology-Oncology 

Building Coordinator and phone no at thislocation: Lisa Wilen or Claudia Aquino 310-784-4477, lwilen@mednet.ucla.edu or caquino@mednet.ucla.edu

41.       Buildingname or address:      19950 Rinaldi Street, 3^rd Floor. Porter Ranch,CA 91326     

Unit within your department: Multi-specialty  

Building Coordinator and phone no at thislocation: Ann Sullivan, asullivan@mednet.ucla.edu

42.       Buildingname or address:      707 S. Garfield Ave., Suite 304, Alhambra, CA 91801         

Unit within your department: Hematology-Oncology  

Building Coordinator and phone no at thislocation: Carlo Arias, carias@mednet.ucla.edu

THIS PAGEINTENTIONALLY LEFT BLANK.

TheUCLA Injury and Illness Prevention Program (IIPP) is a guide to assistuniversity administrators and supervisors to promote the health and safety of theiremployees. This IIPP complies with the Cal/OSHA requirement to provide a safeand healthful workplace for all employees (California Code of Regulations Title8, Section 3203). It establishes methods for identifying and correctingworkplace hazards, providing employee safety training, communicating safety information,and ensuring compliance with safety programs. It is reviewed and updated annuallyto reflect any changes in regulations, personnel or procedures.

Theitems outlined below will be executed by the administrative branch of theDepartment Safety Committee, which includes the Safety Coordinators and theAdministrative Safety Liaison. Please contact Susan Hama with any questions orconcerns: 310-267-2945.

Department Manager

Thedepartment manager must ensure a department-specific IIPP is implemented inareas that fall under his/her control. He/she is responsible for the following:

1.    Communicating management’s commitmentto health and safety of its employees;

2.    Ensuring that areas under his/her controlcomply with internal and external regulations and guidelines;

3.    Providing individuals under his/hermanagement with the authority and resources to develop and implementappropriate health and safety programs, practices and procedures;

4.    Designating a Department SafetyCoordinator; and

5.    Establishing a departmental process(such as a safety committee) to maintain and update the departmental IIPP, assessdepartmental compliance with applicable regulations and campus policies,evaluate reports of unsafe conditions, and coordinate any necessary correctiveactions.

Supervisors

Supervisorsplay a key role in the implementation of the departmental IIPP. They areresponsible for the following:

1.    Encouraging a safe work culture by communicatingUCLA’s emphasis on health and safety to their staff;

2.    Modeling and enforcing safe and healthywork practices;

3.    Ensuring that employees are properlytrained to complete all assigned tasks;

4.    Ensuring periodic inspection ofworkspaces under their authority;

5.    Stopping work that poses an imminenthazard to any employee;

6.    Implementing measures to eliminate orcontrol workplace hazards;

7.    Developing safe work procedures suchas Standard Operating Procedures (SOP) and Job Safety Analyses (JSA);

8.    Providing appropriate safety trainingand personal protective equipment (PPE) to employees under their supervision;

9.    Reporting and investigating workrelated injuries and illnesses;

10. Encouraging employees to report health and safety issueswithout fear of reprisal;

11. Disciplining employees that do not comply with safe workpractices; and

12. Documenting employee training and departmental safetyactivities.

Employees

Allemployees must comply with all applicable health and safety regulations,policies, and work practices. This includes, but is not limited to thefollowing:

1.      Using personalprotective equipment (where required);

2.      Activelyparticipating in all required safety and health training;

3.      Learning about thepotential hazards of assigned tasks and work areas;

4.      Complying withhealth and safety-related signs, posters, warnings and directions;

5.      Requestinginformation related to job safety whenever needed;

6.      Reporting all work-relatedinjuries and illnesses promptly to their supervisor;

7.      Warning co-workersabout defective equipment and other hazards;

8.      Reporting anyunsafe or unhealthy conditions immediately to a supervisor, and stopping workif it poses an imminent hazard;

9.      Cooperating with incidentinvestigations to determine the root cause; and

10.   Participating inworkplace safety inspections.

Department Safety Coordinator orSafety Liaison

TheDepartment Safety Coordinator or Safety Liaison monitors the safety activitieswithin the department and serves as the departmental liaison with EH&S. TheDepartment Safety Coordinator(s) are responsible for the following:

1.   Obtaining relevantinformation regarding safety and health regulations, procedures, and safeguardsaffecting employees within their department;

2.   Planning andcoordinating monthly safety meetings;

3.   Investigating accidentsand incidents to identify and implement any corrective actions necessary toprevent future incidents;

4.   Ensuring thatregular health and safety inspections are conducted within their area of responsibility;

5.   Reporting toEH&S any unsafe or unhealthy conditions, which they cannot correct; and

6.   Maintainingdepartment safety records to document employee training, inspections, safetymeetings and incident investigations.

Department Safety Committees

Departmentbased safety committees are important for a successful campus-wide program.While not mandated, implementation of departmental safety committees is highlyrecommended. Departmental Safety Committees work under the direction of the DepartmentSafety Coordinator or Safety Liaison and are responsible for the following:

1.    Creating, maintaining, and updatingthe departmental IIPP;

2.    Assessing departmental compliance withapplicable regulations and campus policies;

3.    Reviewing workplace inspections toidentify any needed corrections;

4.    Reviewing reports of unsafe conditionsthat cannot be immediately corrected by an employee or supervisor, andcoordinating any necessary corrective action;  

5.    Conducting hazard and incidentinvestigations to assist in establishing corrective actions;

6.    Tracking corrections of workplacehazards;

7.    Reviewing all departmental incidentand injury investigations to ensure that all causes have been identified andcorrected;

8.    Developing suggestions for employeetraining based on reviews of incidents and injuries;

9.    Reviewing employee safety suggestionsand submitting recommendations for corrections to department management; and

10. Preparing written meeting minutes using Departmental SafetyCommittee Meeting Minutes Form (APPENDIX A) or a similar form.

TheDepartmental Safety Committee should meet at least quarterly and haverepresentatives for each employee within the department. Membership may rotateperiodically.

Environment, Health & Safety(EH&S) Injury Prevention Division

TheEH&S Injury Prevention Division (IPD) provides consultation and support toDepartment Safety Coordinators and Safety Committees. IPD safety specialistsprovide support and training to promote a campus-wide safety program. Supportactivities include, but are not limited to the following:

1. Materials for departmental safety meetings and safety initiatives;
2. Assistance with inspections and incident investigations; and
3. Assistance with development of departmental IIPP.

Director of Environment, Health andSafety

TheDirector of Environment, Health and Safety (EH&S) has authority andresponsibility for overall implementation and maintenance of the IIPP. Specificresponsibilities include the following:

1. Interpreting external regulations to develop appropriate compliance strategies;
2. Reviewing methods and procedures to correct unsafe and/or unhealthy conditions;
3. Ensuring that there are procedures to communicate UCLA’s safety and health policies and guidelines to employees; and
4. Monitoring the effectiveness of the overall IIPP and making improvements as needed.

Inspection Program Overview

Safetyinspections identify and evaluate workplace hazards and conditions that couldresult in illness, injury or property damage. Managers and supervisors mustensure that safety inspections are conducted on a regular basis. Inspectionsmust also be completed when management is made aware of existing or new hazardsin the workplace.   

The Departmental Safety Coordinator or SafetyLiaison is responsible for identifying workplace hazards. These individuals areresponsible for ensuring that periodic inspections are completed to assess,record, and correct hazardous and potentially hazardous conditions that mayexist. The inspections may be conducted by the Department Safety Coordinator,Safety Committee, supervisors or other assigned personnel.

Scheduled SafetyInspections

Alladministrative departments, shops and laboratories must complete workplacesafety inspections. By law, the first of these inspections must take place whenthe department first adopts a department specific IIPP. Inspections aredocumented and reviewed by management, the Department Safety Coordinator,and/or the Department Safety Committee. Ongoing inspections will take place asindicated below:

OFFICES – Annual inspections of all officeareas will be completed to detect and eliminate any hazardous conditions thatexist. The Office Inspection Checklist, or similar form, can be used tocomplete inspections. The “Computer Workstation Checklist” (APPENDIX A) isavailable to evaluate computer workstations. Computer workstations can also becompleted using the BruinErgo Office Ergonomic Solutions (OES) on-line program,or by contacting the EH&SErgonomics Division for assistance at www.ergonomics.ucla.edu. 

LABORATORIES – Annual inspectionsof all laboratories are required (semi-annual inspections suggested as bestpractices) to detect and eliminate any existing hazardous conditions using the LaboratoryInspection Checklist, or similar form (APPENDIX A). One of theseinspections will be completed by the Chemical Hygiene Officer or an EH&SLaboratory Inspector; the second inspection can be completed by the Laboratory Manager,Principal Investigator (PI), Safety Coordinator or designee.  

Unscheduled SafetyInspections

Unscheduled safety inspections will becompleted whenever new substances, processes, procedures, or equipment areintroduced into the workplace and present new safety or health hazards.Additional inspections will be completed whenever management is informed ofpreviously unrecognized hazards.

Reporting Hazards orUnsafe Work Practices

Employees are encouraged to report existingor potentially hazardous conditions or unsafe work practices to theirsupervisor so that necessary action (including training, purchase ofappropriate equipment, etc.) can be taken in a timely manner. The HazardNotification/Safety Recommendation Form (APPENDIX A), or similar form, can be used to report unsafeconditions.

Supervisors, the Safety Coordinator or Liaison,or members of safety committees should complete the Hazard Notification/Safety RecommendationForm when made aware of an unsafe condition for which an immediate remedy cannotbe implemented. The form can be used to document controls implemented to reduceor eliminate any unsafe conditions.  Corrective actions shall be identified andcompleted by the department, and the form shall be filed internally fordocumentation purposes.

For additional assistance with the HazardNotification/Safety Recommendation Form and/or identification of theappropriate corrective actions, please contact EH&S Injury PreventionDivision at injuryprevention@ehs.ucla.edu.Employees who report such conditions cannot be disciplined or suffer anyreprisals. Complaints can be made anonymously.

Hazard Correction

Hazard levels range from being imminentlydangerous to relatively low risk. Corrective actions or plans, includingsuitable timetables for completion, are the responsibility of the department.EH&S consultation is available to determine appropriate abatement actions. 

Corrective actions or plans must beappropriate for the severity of the hazard. If an imminent hazard exists, workin the area should cease, and the appropriate supervisor be contacted. If thehazard cannot be immediately corrected without endangering employees orproperty, evacuate all unnecessary personnel from the area. Individualsentering the hazard area to correct the condition must have protectiveequipment and other necessary safeguards before addressing the situation.

Specific procedures that can be used tocorrect hazards include, but are not limited to, the following:

1.    Stopping unsafe workpractices and providing retraining on proper procedures before work resumes;

2.    Reinforcing use ofand providing personal protective equipment (PPE);

3.    Lock-out/tag-out ofunsafe equipment;

4.    Isolating orbarricading areas that have chemical spills or other hazards to deny accessuntil appropriate correction is made; and

5.    Reporting problems orhazardous conditions to a supervisor, EH&S Hotline at 310-825-9797, or FacilitiesTrouble Call Desk at 310-206-8496.

Supervisors can seek assistance in developingappropriate corrective actions by submitting a Hazard Notification/SafetyRecommendation Form (APPENDIX A) to their Department Safety Committee, SafetyCoordinator or liaison, or EH&S.

Hazard CorrectionReport

The Hazard Identification/Correction Form(APPENDIX A), or similar form, must be used to document corrective actions,including projected and actual completion dates. This form can be attached to safetymeeting minutes to document hazard correction activities completed by thedepartment.

Supervisors

Supervisors are responsible for communicatingsafety and health issues in a form readily understandable by all workers. Alldepartment personnel are encouraged to communicate safety concerns to theirsupervisor without fear of reprisal.

Safety Committee

The Departmental Safety Committee serves as theprimary resource for communicating health and safety issues to departmentemployees. Each employee is represented by a member of the safety committee.This representative is responsible for communicating information concerning hazardidentification and correction. Safety Committee minutes are posted or availableat a convenient location in the department.

The Safety Committee can also sponsorseminars or speakers, or coordinate other means to communicate with employeesregarding health and safety matters.

Resources

While supervisors have primary responsibilityfor providing employees with hazard information pertinent to their workassignments, information concerning safety hazards is available from a numberof other sources. Safety information is communicated to employees by e-mail,voice mail, distribution of written memoranda, or by articles in internaldepartmental newsletters (if applicable). Other resources include, but are notlimited to the following:

EH&S Website andNewsletters

The EH&S websitehas extensive health and safety information and resources for employees. Healthand safety specialists can be contacted through the website to answer inquiriesand provide assistance to employees. News & Notes, EH&S'quarterly newsletter, offers safety information on workplace safetyand illness prevention. Visit the EH&Swebsite for more information.

Safety Bulletin Boards

EH&S maintains safety informationand regulatory requirements on safety bulletin boards located throughoutcampus. Postings include emergency contact information, worker’s compensationpostings, Cal-OSHA announcements and updates. Visit the Cal/OSHA website at www.dir.ca.gov/dosh for more information.

Material Safety DataSheets

Material Safety DataSheets (MSDS) provide information on the potential hazards of products orchemicals. The University of California uses an electronic database at www.ucmsds.com available to all employees.For those employees who do not have access to a computer hard copies of MSDSfor the chemicals they are using must be made available to them in a convenientlocation. MSDS fact sheets, hazardous communication videos, and other trainingmaterials are available from the manufacturer and/or EH&S.

StandardOperating Procedures (SOPs)/ Job Safety Analysis’ (JSAs)

Thepurpose of an SOP or JSA is to recognize hazards associated with the operationof a piece of equipment or task and determine how to control those hazards. SOPsand JSAs are available for tasks and equipment that present hazards to employees.Components of the JSA include:

1.    Pictureof equipment or task

2.    Tasksassociated with use of equipment or job that have hazards

3.    Risksassociated with tasks

4.    Solutionsto reduce risk

5.    RecommendedPPE

Refer to APPENDIX Afor JSA/SOP template and example; refer to APPENDIX C for a list ofDepartmental JSA’s.

Equipment OperatingManuals

All equipment must beoperated in accordance with the manufacturer’s instructions as specified in theequipment’s operating manual. Copies of operating manuals must be kept witheach piece of equipment used in the department. Employees are required toreview and demonstrate understanding of the SOP/JSA or the operating manualbefore using the equipment.

Safety Manuals

EH&S has area andjob-specific safety manuals in addition to the IIPP, including the Shop SafetyManual, Chemical Hygiene Plan, Laboratory Safety Manual, Biohazard SafetyManual, Radiation Safety Manual and the Laser Safety Manual. These manualsprovide general guidelines for these jobs and areas and are available at theEH&S website www.ehs.ucla.edu.

EmergencyResponse Plan

The UCLA Emergency Response Plan addresseslife and safety issues that emerge as a result of a disaster, emergency, catastrophicevent or calamity (e.g., earthquake, fire, flood, loss of criticalinfrastructure, terrorist attack, civil unrest, etc.). The UCLA FacilitiesEmergency Management team provides campus departments with an Emergency ResponsePlan template which incorporates the critical elements necessary for adepartment-specific plan. Visit the UCLAEmergency Response Plan website for more information.   

Business Continuity Plan

A Business Continuity Plan is used to helpyou to continue your operations once life and safety have been secured. Although the two plans work hand in hand, theBusiness Continuity Plan is different from an Emergency Response Plan in thatthe former describes a departmental plan of action that can be taken to lessen theimpact of disruptions, while the latter describes how to prepare and respond tothese disruptions. The Office of Insurance and Risk management assists campusdepartments with developing a Business Continuity Plan using the “UC Ready”software tool. Visit the IRMBusiness Continuity website for more information.

An incident is an unplanned event whichresults in an accident, injury, illness or property damage. A near missis an unplanned event that did not result in an accident, injury, illness, ordamage, but had the potential to do so. Both incidents and near misses are reportedand investigated to implement procedures to reduce the likelihood of futurereoccurrence.  

Incident, Injury andIllness Reporting and Treatment

Employees who are injured or become ill at workmust report the injury or illness immediately to their supervisor and personneldepartment. The supervisor must provide employees with the level of medicalattention required for the situation.

Medical Treatment

For non-emergencymedical treatment of work-related injuries or illnesses, employees should besent to the OccupationalHealth Facility (OHF) at CHS 67-120 during normal business hours, or the Emergency Medicine Center (EMC) at the Ronald Reagan/UCLA MedicalCenter (RRMC) at 757 Westwood Plaza after normal work hours.

If immediate medicaltreatment beyond first aid is required, call 911 from a campus phone, or contactUCPD dispatch at 310-825-1491 from off-campus or cell phones. If working at asite other than the main UCLA campus, use the nearest designated medicalfacility for your organization.

Forms

Supervisors mustcomplete and provide injured employees with the UCLA Incident Report &Referral for Medical Treatment form to take to the treating facility. If theinjury is more than first aide treatment, also provide the employee with a“Workers’ Compensation Claims Form (DWC-1) & Notice of Potential Eligibility”form (APPENDIX A).

Reporting

All injuries must bereported to Insurance and Risk Management (IRM) within 24 hours. Injuries thatmeet the Cal/OSHA definition of “Serious Injury” must be immediately reportedto the EH&S Hotline at 310-825-9797 (APPENDIX A).

Serious Injuries

Serious occupationalinjuries, illnesses or exposures to hazardous substances, as defined byCal/OSHA, must be reported to EH&S immediately when they become known to managersor supervisors. Serious injuries include deaths, amputations, concussions,crush injuries, fractures, burns, lacerations with significant bleeding orrequiring stitches, or hospitalization (other than for observation) for greaterthan 24 hours. Supervisors must report injuries that meet the Cal/OSHAdefinition of Serious Injury to the EH&S Hotline at 310-825-9797 as soon asthey are notified of the injury. Required information includes the name of theinjured employee, a brief summary of the incident, description of the injuriesobtained by the employee, and a number where the reporting supervisor can bereached.  EH&S must report the injury to Cal/OSHA within eight hours ofoccurrence. Departments are responsible for payment of up to a $5000 finefor late reporting. EH&S will conduct an incident investigation with arepresentative from the injured employee’s department to determine anycontributing conditions and develop corrective action plans.

Incident Investigations

The employee’s supervisor is responsible forperforming an investigation to determine and correct the cause(s) of anincident. Specific procedures that can be used to investigate workplace incidentsand hazardous substance exposures include:

1.    Interviewing injuredpersonnel and witnesses;

2.    Examining the injuredemployee’s workstation for causative factors;

3.    Reviewing establishedprocedures to ensure they are adequate and were followed;

4.    Reviewing trainingrecords of affected employees;

5.    Determining allcontributing causes to the incident;

6.    Taking correctiveactions to prevent the incident/exposure from reoccurring; and

7.    Recording allfindings and corrective actions taken.

The supervisor’s findings and correctiveactions must be documented using the Incident Investigation form (APPENDIX A) orsimilar form. If the supervisor is unable to determine the cause(s) and implementappropriate corrective actions, assistance is available from resourcesincluding Department Safety Coordinators, Safety Committees, EH&S, or IRM.

The Department Safety Coordinator, or SafetyLiaison, must review the investigation report to ensure that the investigationwas thorough and that all corrective actions are completed. Investigationsand/or corrective actions that are found to be incomplete should be routed backto the supervisor for further follow-up. All corrective actions that are notimplemented in a reasonable period of time must be discussed with the departmentmanager. EH&S safety specialists are available to help resolve outstanding issuesand problems.

Effective dissemination of safetyinformation is essential for a successful IIPP. All employees must be trainedin general safe work practices, including specific instructions on hazardsunique to their job assignment. Minimal training requirements include safe useof workplace equipment, manual materials handling, identifying hazards in workarea, use of personal protective equipment, safe handling of hazardousmaterials, and proper procedures for disposal of hazardous waste. Training mustbe completed before use of any dangerous equipment, exposure to any knownhazardous conditions, or when new hazards are identified.

Managers must ensure supervisors are trainedto recognize and abate safety and health hazards to which their employees areexposed. Supervisors are responsible for ensuring their employees receiveappropriate safety training and for documenting that this training has beenprovided. Attendance at training classes and safety meetings is required. Documentationof individual safety training and safety meetings must be kept by theDepartment Safety Coordinator or safety liaison and copies can be kept inAPPENDIX D.

Safety Training

Cal/OSHA mandates that all employeesparticipate in periodic safety trainings during which topics relevant to theworkplace are reviewed and discussed. Safety training meetings can include statusreports on safety inspections, hazard mitigation projects, incidentinvestigation results, and employee safety suggestions. Safety trainings can beincorporated into staff meetings, presented during “tailgate” meetings, orconducted via one-on-one coaching. The duration of safety meetings can varybased on the subject and training format.

As best practices, all employees should completetraining in the following areas:

1.    Illness and InjuryPrevention Program;

2.    Fire Safety;

3.    EmergencyPreparedness/Earthquake Safety;

4. Safety Lifting/Back Injury Prevention;

5.    Hazard Communication& Awareness (Use of MSDS);

6. General Safety and Housekeeping;

7.    Specific hazardinstruction unique to the job assignment such as hazardous waste, fire diamond,blood borne pathogens, power tool safety, laser safety, radiation safety, etc.; 

8. Hazard instruction related to introduction of new substances, processes, procedures or equipment introduced to the workplace; and
9. Hazard instruction of new or previously unrecognized hazards.

Modules for one through six above areattached in APPENDIX B. Online modules and course information for item sevenabove can be found at the EH&S website www.ehs.ucla.edu, or by contacting training@ehs.ucla.edu.The Cal/OSHATraining and Instruction Requirements website at www.dir.ca.gov/dosh has more informationon mandated safety trainings required by the State of California.

Documentation

Cal/OSHA regulations require that records foroccupational injuries and illnesses, medical surveillance, exposure monitoring,inspections, and other safety activities be maintained for specific periods oftime. Records must be kept in employee personnel files following Universityguidelines. Department personnel representatives must present them to Cal/OSHAor other regulatory agency representatives if requested. EH&S may reviewthese records during routine compliance inspections.

Safety Training

Employee training must be provided atno cost to the employee during the employee’s normal working hours. Safetytraining may be provided by a knowledgeable supervisor or department member, orby representatives from other relevant campus departments and approved vendors.All safety training must be documented using the Training Documentation Form(APPENDIX D) or similar form, and must include:

1.       Date of training;

2.       Name of trainer;

3.       Topic;

4.       Name, department, IDnumber, and signature of each attendee; and

5.       Outline of safetytopic (may be attached).

Keep copies of all traininglogs in APPENDIX D.

Safety InspectionReports

The Department SafetyCoordinator or Safety Liaison, human resources specialist, or area supervisoris responsible for maintaining safety inspection records and reports. Therecord must include the following:

1.       Name of inspector;

2.       Date of inspection;

3.       Any identified unsafeor unhealthy condition or work practice; and

4.       Corrective action(s)to remedy the identified hazard(s). 

Keep copies of allsafety inspection reports in APPENDIX E.

Recordkeeping

The following records must be kept on file inthe department for the minimum times indicated below:

1.       Safety inspectionforms = 5 years;

2.       Hazard identificationforms = 5 years;

3.       Incidentinvestigations = 5 years;

4.       Safety postings andsafety meeting agendas = 5 years;

5.       Safety trainingchecklists and related training documents = Duration of each individual’semployment; and

6.       Exposure records, orother employee medical records = 30 years or for the duration of eachindividual’s employment if > 30 years. Access to employee medical recordswill be limited in accordance with University policies, state and federalguidelines.

Compliance is critical for an effective Injury& Illness Prevention Program. Managers and supervisors serve as role modelsfor working safely and provide resources necessary to ensure a safe workenvironment for their staff. All employees are required to follow safetypolicies and operating procedures. Employees will be provided with safetytraining and information to complete all assigned duties safely. When needed,employees will be provided with additional training and information, or re‑trainingto maintain their knowledge of campus safety policies and procedures.

Employees who demonstrate safe work practicesmay be rewarded through the use of performance evaluations or incentiveprograms. Any employee, who demonstrates repeated unsafe, unhealthy workpractices, will be subject to corrective action and/or disciplinary action.Disciplinary action will be in conformance with UCLA policies and/or correctivebargaining agreements. If the offense is egregious or willful, the action mayresult in immediate disciplinary action. The Employee‑Labor RelationsDepartment must be consulted on any disciplinary matter as it relates to compliancewith this program.

THIS PAGEINTENTIONALLY LEFT BLANK.

This appendix includes the followingchecklists, forms and safety related documents:

1.           Howto Use a Self-Inspection Checklist

2.           OfficeInspection Checklist

3.           ComputerWorkstation Checklist

4.           HazardNotification/Safety Recommendation Form

5.           HazardIdentification/Correction Form

6.           DepartmentalSafety Meeting Minutes Form

7.           JobSafety Analysis Form

8.           JobSafety Analysis Example

9.           Injuryand Illness Reporting Procedures

10.         SeriousInjury Poster

11.         InjuryReporting and Treatment Flow Chart

12.         IncidentReport & Referral for Medical Treatment

13.         Workers’Compensation Claim Form (DWC-1)

14.         IncidentInvestigation Form

15.         Guidefor Completing Incident Investigations

16.         DisciplinaryAction Guidelines

17.         LabSafety Inspection Form

18.         LaboratorySafety Inspection Process

THIS PAGEINTENTIONALLY LEFT BLANK.

The Office of Environmental Health and Safety(EH&S) has developed a self-audit Office Inspection Checklist to assistdepartments in eliminating workplace hazards. The checklist can be used by anentire department, a section of a department, a particular room or anindividual to document findings from regular inspections.

The EH&S Office Inspection checklist canbe modified for development of a customized checklist to meet your department’sspecific needs. 

The checklist is for internal departmentaluse. There is no need to send copies of completed checklists to EH&S. Ifassistance from EHS is desired, please contact us at (310)825-5689.

Thereare a series of self-audit checklists available from EH&S for a variety ofwork settings.  They include the following:

• Office Safety Checklist
• Computer Workstation Checklist
• Floor Inspection Checklist (Slip and Fall Prevention Program)
• Laboratory Safety Inspection Checklist
• Shop Inspection Checklist
• Materials Handling Checklist

Thechecklists can be downloaded from the EH&S website www.ehs.ucla.edu. The Web version of the Health and SafetyGuide allows the user to download Microsoft Word files containing thechecklists. This version of the checklists allows the user to customize thechecklist.  Hard copy versions of the checklists can be requested from EH&S.

Safety inspections should be completedannually by someone familiar with the workplace, tasks and jobs. Any problemsfound must be corrected. Assign an individual to develop a correction forproblems and set deadline for corrections to be completed. The HazardIdentification Record Form can be used to document the correction process.

Inspections should be reviewed for trends todetermine if problems are re-occurring. Re-occurring problems need to beaddressed at Safety Committee Meetings and a corrective plan should be agreedupon. 

If you have any questions about the inspectionchecklists, contact EH&S at x55689 or injuryprevention@ehs.ucla.edu .

THIS PAGEINTENTIONALLY LEFT BLANK.

InspectedBy/Department: __________________________________  Date: ____________

Contacts

Administrative & General Safety……………………….……..EH&S InjuryPrevention Division 310-825-9797

Ergonomics/Computer Workstation……………………....…….….EH&S ErgonomicsDivision 310-794-5590

Earthquake & Fire Protection/Electrical……….....…..BuildingManager or EH&S Fire Safety 310-825-2684

There are noreprisals for expressing a concern, suggestion or complaint regarding safetymatters.

Employees who are injured or become ill atwork must report the injury or illness immediately to their supervisor andpersonnel department. Follow the procedures below as appropriate for thesituation:

1. Get the employee medical attention

a.    For non-emergencymedical treatment for work-related injuries or illnesses

i)      Between 7:30 AM and4:30 PM Monday-Friday, send the employee to the Occupational Health Facility(OHF) at 67-120 CHS, 10833 Le Conte Avenue  (Telephone 310-825-6771)

ii)     After OHF hours, usethe Emergency Medicine Center (EMC) at RonaldReagan/UCLA Medical Center (RRMC), 757 Westwood Plaza, ER entrance off Gayley Avenue , north of Le Conte. (Telephone 310-267-8400).

iii)    If working off themain UCLA campus, use the nearest designated medical facility for yourorganization. Your Human Resources consultant can direct you to the appropriatefacility. 

b.    Immediate medicaltreatment beyond first aid

                                         i.  Call 911 from acampus phone, or 310-825-1491 from off-campus or from your cell phone tocontact UCPD dispatch.

                                        ii.  UCPD Dispatch willsend medical responders to transport the employee to the appropriate hospitalor medical center. 

2. Complete the “UCLA Incident Report & Referral for Medical Treatment” form

a.    Employee and/orsupervisor should complete and sign the top two sections.

b.    Send the form withthe employee to the medical provider or facility.

c.    The doctor or medicalprovider will complete the bottom section of the form indicating type oftreatment provided, return to work status, work restrictions, and any futureappointments.

d.    The employee shouldreturn the form to the supervisor (if the supervisor does not accompany theemployee to the medical facility).

e.    The employer shouldtry to accommodate any temporary work restrictions.

f.     If there arequestions concerning work restrictions and accommodation, contact theTransitional Return to Work Coordinator at 310-794-6955.

3. If the injury is more than first aid treatment, provide the following forms to the employee in addition to the “UCLA Incident Report & Referral for Medical Treatment” form:    

a.    “Workers’Compensation Claims Form (DWC-1) & Notice of Potential Eligibility” form

                                         i.    Supervisor shouldcomplete bottom section 9 through 17, sign the form, and give to employee. Keep a copy of the completed form for department records, and send a copy toPayroll/Personnel and Insurance and Risk Management. 

                                        ii.    Employee shouldcomplete top section of form and return to employer. 

4. Report injuries

a.    All injuries must bereported to Insurance and Risk Management within 24 hours

                                         i.  Call 877-682-7778 toreport injuries 24/7

                                        ii.  FAX completed formsto 310-794-6957

(1)  UCLA Incident Reportand Referral for Medical Treatment

(2)  Workers’ CompensationClaim Form (DWC 1)        

5. Serious injuries

Serious occupationalinjuries, illnesses or exposures to hazardous substances, as defined byCal/OSHA, must be reported to EH&S immediately when they become known tomanagers or supervisors. Serious injuries include amputations, concussions, crushinjuries, fractures, burns, lacerations with significant bleeding or requiringstitches, or hospitalization (other than for observation) for greater than 24hours. Call the EH & S Hotline at 310-825-9797 to report any injury thatyou think meets the Cal-OSHA definition of a serious injury. Informationrequired includes the name of the injured employee, a brief summary of theincident, description of the injuries obtained by the employee, and a numberwhere the reporting supervisor can be reached.  EH & S must report theinjury to Cal-OSHA within eight (8) hours of occurrence. Departments areresponsible for payment of up to a $5000 fine for late reporting. An incidentinvestigation will be conducted by EH&S in conjunction with arepresentative from the injured employee’s department.

6. Student workers & volunteers
1. Student workers should go to Arthur Ash Student Wellness Center for Medical Treatment during regular business hours 310-825-4076, and go to Ronald Reagan Medical Center after hours.
2. Volunteer works should go to their designated medical facility or to Ronald Reagan Medical Center in case of emergency.

InjuryReporting and Treatment Flowchart

University of California Los Angeles

INCIDENT REPORT & REFERRAL FOR MEDICAL TREATMENT

IncidentReporting is required and ensures that there is a record on file with theemployer.  If an employee is injured or develops a job-related illness(developed gradually over time) as a result of their employment at UC, theymust complete and submit this form.  If the employee is unable to complete thisform, the supervisor must complete it on their behalf.  If an injury occurs,first aid may be the appropriate treatment.  If you have any questions, pleasecall your Campus Workers’ Compensation representative at:  Insurance & RiskManagement (IRM) 310-794-6948 or Health System Human Resources (HS/HR) 310-794-0500. 

EMPLOYEE: Return this form to your department after you have been seen at theOccupational Health Facility (OHF)

DEPARTMENT:  within 1 day of the incident, Call877-682-7778 24 hr report or Fax to 310-794-6957 or

Email to wcreports@irm.ucla.edu

Employee Completes THISSection:

Date of report: ____________________  Check one  oUCLA Campus oUCLA MedicalCenter oSanta Monica UCLA  o NPH/I  

Sex:  o Male   o Female                             Check one o Part-time   o Full-time   o Student   o Volunteer           

Name PRINT: Last__________________________________ First ___________________________ SSN__________________________

Home Address: _________________________________________ City: ___________________________   Zip: _____________________

Home Phone:_______________________________________ Work Hours (Shift):_____________________________________________

Department:____________________________ Job Title: ___________________ Work phone:___________________________________

Do you have other employment?  o Yes   o No   If yes, where:_____________________________________________________________

Date of Incident: _______________Time of Incident:_______AM_PM  Describe what you were doing: ____________________________

_________________________________________________________________________________________________________________

Describe all injured body parts (e.g.bruised elbow):_______________________________________________________________________

Were there witnesses?    o Yes   o No   o Unknown  Name(s):_____________________________________________________________

Is this a new injury?  o Yes   o No   If “no”, please indicate date of original injury:_____________________________________________

INITIALMEDICAL TREATMENT   

o Nomedical treatment; reporting only   o Declined treatment at this time             o Treatment was/will be provided

Treatment was provided by: o Self         o Occupational Health            o Emergency Room                o Other (please specify below)

Name:___________________________________________________________________________________________________________

Address:_____________________________________________________   Phone:_____________________________________________

I, theinjured employee, herein certify the information above is true and to best ofmy knowledge:

Date: _______________________   Signatureof Employee: ________________________________________________________________

SUPERVISOR/EMPLOYEECOMPLETES THIS SECTION:

Supervisor Name:________________________________________ Emailaddress_______________________________________________

Work Phone:_______________ Was the incident reported to you? o Yes   o No   Date reported: ___________________________________

Address/Bldg, name & room # wherethe incident occurred: __________________________________________________________________

Describe how the employee was injured:_________________________________________________________________________________

__________________________________________________________________________________________________________________      

Did employee lose time from work?    o Yes   o No   o Unknown    First day off work due to injury: ________________________________

Was theEmployee paid for the full date of injury?   o Yes   o No   Date Employee returned to work: ________________________________

Was equipment/chemical involved? o Yes   o No   If answered “yes” what was theequipment/chemical:_____________________________

__________________________________________________________________________________________________________________

Was employee exposed to blood/bodilyfluid other than his/her own? o Yes o No   Sourcename/MR # ______________________________

What action will be taken to preventrecurrence? ___________________________________________________________________________

Date: ________________ SupervisorSignature: ___________________________    Title:________________________________________

Incident:   Report Only  Accident/Injury  Serious Injury  Other _____________

Worker’sCompensation:     No     Yes Claim No. _____________

Affected Employee:

Interviewees: (Affectedemployee, witnesses, supervisor, etc.)

Investigator:

IncidentDescription:

Resultsof Investigation:

RecommendedCorrective Actions:

CompletedCorrective Actions:

Attachments:(photos, additional documentation, etc.)

PURPOSE

When incidents occur on the job, aninvestigation must be completed to identify the root cause and contributingfactors that led to the incident. Supervisors must complete any repairs andimplement procedural changes to correct conditions contributing to theincident. Doing so will decrease the likelihood of the incident reoccurring inthe future. This handout summarizes the necessary steps in conducting aneffective incident investigation, completing a thorough report and implementingthe necessary corrective actions.

INCIDENT INVESTIGATION AND REPORT

• Investigate the incident as soon as possible.
• This ensures that the gathered facts are fresh in the mind of the interviewee(s).
• Preserve the scene and document the investigation.
• Document any physical changes observed at the incident site. Photograph or videotape the scene and potentially defective equipment so that the conditions of the incident are captured.
• If interviewing more than one person, conduct separate meetings with each interviewee.
• This improves accuracy in that it allows interviewees to develop their own statements without being influenced by statements provided by others.
• Be very detailed and include specifics in the investigation report.
• Who?
• Incidents usually involve more people than just the injured employee. This includes witnesses and persons who may have contributed to the incident.
• What?
• Verify what the employee was doing when the incident occurred. What specific task was the employee performing? What equipment was involved? Was the proper training completed?
• When?
• It is important to indicate the time and date the incident occurred. This provides an idea of the turnaround time in which injuries are being reported. This is especially important for OSHA recordable injuries, which are time sensitive. 
• Where?
• Be as detailed as possible when describing the scene of the incident. Make note of spilled contents on the floor, cords across walkways, and other observed hazards. Indicate whether or not the employee was in his/her common work area or performing a task in another work environment.
• Why?
• Compile all of the above information to develop an objective reason as to how and why the incident occurred. Why was the employee performing that task? Why did the equipment malfunction? Was it a defective piece of equipment or a user error?

IMPLEMENTINGCORRECTIVE ACTIONS

• Review the incident investigation report and document corrective actions.
• Determine the root cause of the incident and identify what can be done differently to reduce the likelihood of reoccurrence. Discuss the specific events that may have led to the incident. Exhaust the question “why?” until the root cause is identified. Refer to the example below:
• Incident: Joe was using a ladder to perform a routine maintenance task in the warehouse when Paul came by on a forklift and ran into the ladder, causing Joe to fall.
• Why was the ladder hit by the forklift?
• The operator did not see Joe.
• Why did Paul not see Joe?
• The operator was transporting a large load that blocked his vision.
• Why was the load blocking Paul’s vision?
• He was driving forward instead of backwards as trained to do so when operating with a large load.
• Why was Paul driving forward instead of backwards?
• Paul had forgotten this rule regarding safe forklift operation procedures.
• Review contents of the incident investigation report with the safety committee and identify possible solutions. Some general corrective actions may include the following:
• Repair and/or replacement of faulty equipment per lock out/tag out procedures.
• Revision to current safety procedures associated with job task (implement 2-man lifts, spotters for forklift operators, job rotation, etc.)
• Disciplinary actions for violation of safety protocol (documentation of verbal warning and/or write up, suspension from job or termination).
• Job hazard analysis outlining known hazards associated with job task and preventative actions for each.
• The following are some solutions for the example presented above:
• Refresher safety training for forklift operators and warehouse employees.
• Have a helper at the foot of the ladder who can warn oncoming traffic.
• Have a spotter for forklift operators.
• Notify warehouse when maintenance work will be performed.
• Follow up procedures must be in place to ensure the timely completion of corrective actions:
• As best practices, a 30-day completion period should be applied to safety recommendations.
• Intermittent corrective actions should be applied to hazards posing immediate exposures until recommendations can be completed (stanchion posts delineating unlevel flooring, cones around spills, LO/TO of machine with no guards, etc.).

* Investigativereports should be retained by the Department Safety Coordinator for five years.The Office of Environment, Health & Safety (EH&S) is available for andassistance to remedy any outstanding problems.

ContactInformation:

EH&SInjury Prevention Division

Tel:310-825-5689, injuryprevention@ehs.ucla.edu 

www.ehs.ucla.edu

Per UCProcedure 62, corrective action is intended to improve and/or correct theconduct or performance of regular status professional and support staffmembers. Supervisors shall apply necessary and appropriate corrective actionwhenever an employee fails to meet the required standards of conduct orperformance. Consult your HR representative before implementing disciplinaryaction.

TYPES OF CORRECTIVE ACTION

Corrective actions include but are notlimited to written warnings, corrective salary decreases, demotions,suspensions and termination.

For exempt employees, suspension without paymay be imposed only in increments of one work week. However, suspension withoutpay in increments of less than a work week may be permitted when the infractionis a violation of a significant safety rule relating to prevention of seriousdanger to the workplace or other employees.

A.   WRITTEN WARNING

At least one written warning shall precedeany other more serious corrective action except when corrective action is theresult of performance or conduct which an employee knows or reasonably shouldhave known was unsatisfactory. Such performance or conduct may include but isnot limited to violations of law, dishonesty, theft or misappropriation ofUniversity property, fighting on the job, insubordination, acts endangeringothers, or other serious misconduct.

B.   WRITTEN NOTICE OFINTENT TO TAKE CORRECTIVE ACTION

Written notice of intent to take correctiveaction is required, except for a written warning or a suspension pursuant toStaff Policy 64.D. The notice shall state the intended action, the reason, andthe effective date, and shall include a copy of the materials on which thecorrective action is based and state the employee's right to respond orally orin writing within 8 calendar days from the date of issuance of the notice.

After consideration of the employee'sresponse, if any, the employee shall be notified in writing of the action to betaken, the effective date of the action, and the employee's right to reviewunder Staff Policy 70, Complaint Resolution.

C.   RECORDS OF CORRECTIVEACTIONS

Records of corrective actions shall bemaintained in accordance with local procedures, except that records ofcorrective actions taken in response to complaints filed by a member of thepublic against employees in police titles shall be retained for at least fiveyears and shall be filed as required by California Penal Code Section 832.5.

Applicability: Professional and Support Staff

THIS PAGEINTENTIONALLY LEFT BLANK.

THIS PAGEINTENTIONALLY LEFT BLANK.

This appendix includes the following trainingguides that can be used to facilitate the suggested safety trainings for thedepartment:

1.    Illness and InjuryPrevention Program

2.    Fire Safety

3.    Emergency Preparedness/EarthquakeSafety

4.    Safe Lifting/BackInjury Prevention

5.    Hazard Communicationand Awareness

6.    General Safety andHousekeeping

THIS PAGEINTENTIONALLY LEFT BLANK.

Effective dissemination of safetyinformation is an integral part of the Injury and Illness Prevention Program(IIPP).  This document was created to facilitate worker safety training. Training must be completed before the use of any tool or piece of equipment,exposure to any hazardous condition, or when new hazards are identified. 

Objectives of theIIPP

The IIPP is designedto maintain a safe and healthy work environment on campus. Required by law, itcomplies with California Code of Regulations Title 8, Section 3203.  By havingan IIPP, UCLA management demonstrates a commitment to and concern for employeesafety. In addition to providing employees and students with a safe workenvironment, the IIPP assures compliance with health and safety codes whileimproving worker efficiency and reducing costs related to work-relatedillnesses and injuries.

Supervisor &Employee Responsibility

Supervisors areresponsible for carrying out the duties required to implement and enforce theIIPP in the areas they supervise. Supervisors must provide employees withgeneral and job specific safety training, and make sure employees wearappropriate personal protective equipment (PPE). They must also identify andcorrect any hazards in the workplace. They are also responsible for takingdisciplinary actions against any employee that does not follow safety policiesand procedures when working.

Individual employeesare responsible for following work procedures and safety guidelines for anytask they complete. This includes the use of required PPE. If employees do notknow how to safely complete a job, they must ask for needed instruction andtraining. When they see any safety hazards or issues, they must report them tosupervisors.

How to IdentifyHazards

Ahealth and safety inspection program reduces unsafe conditions that exposefaculty, staff, students, and visitors to incidents that could result inpersonal injuries or property damage.  It is the responsibility of eachdepartment to ensure that appropriate, systematic safety inspections areconducted on a regular basis. Periodic inspections must be completed in alldepartments. using the Self-Inspection Checklist, located in the IIPP manual.Records of all inspections must be kept in the IIPP Manual for a period ofthree years.  

Otherways that hazards can be identified is through the use of Employee SafetyRecommendation forms, or by including safety as an agenda item during staff,safety, or tailgate meetings.  Employees cannot be reprimanded for reportingany safety issue.  

AJob Safety Analysis (JSA) can be used to analyze high hazard activities. A JSA describes job tasks in step-by-step fashion,identifies associated hazards at each step, and outlines proper hazard controlsthat minimize the risk of injury or illness to the individual(s) performingthat task.

Hazard Mitigation

The purpose of Safety Inspections is toidentify safety issues or hazards. Once a hazard has been identified, it mustbe investigated so it can be reduced or eliminated.   The HazardIdentification/Correction Form in the IIPP Manual provides a way of recordingthe mitigation of hazards that have been identified through an inspection. As mentioned above, the JSA can also be used to mitigatehazards associated with specific tasks.

Discussion Points:

·        Howdoes an IIPP help employees maintain a safe working environment?

·        Whatare the safety responsibilities of each employee?

·        Whattool is used to identify safety hazards?

·        Wherecan employees locate inspection reports that have been done?

·        Whatshould employees do if they see a hazard in the workplace?

·        Whatare some ways employees can report safety issues or safety hazards?

·        Whatare some hazards that have been reduced or eliminated in your department duringthe last year?

AccidentInvestigations

Supervisors must investigate any accidents,injuries, occupational illnesses, and near-miss incidents that occur in theareas they supervise. Basic questions that must be answered during theinvestigation include: who, what, when, where, and why. An accidentinvestigation guide and form are located in the IIPP Manual to help investigateany incidences that occur. The purpose of completing the investigation is todetermine the cause and make any repairs or procedural changes to avoid futureillnesses and injuries.

Training

The best way to maintain a safe workenvironment is to make sure employees are aware of the hazards and safetyprocedures associated with their jobs. All employees must be trained in generalsafe work practices during their orientation. Specific training on dealing withany hazards unique to each employee’s job assignment must be provided before he/shebegins work. All training must be documented. Training can be completed duringgroup safety training programs, or one-on-one sessions with supervisors ortheir designees. If employees do not have the training required to complete ajob safely, they must inform their supervisors so they can be trained beforebeginning work.   

Communication

In addition totraining, two-way communication between employers and employees is essentialfor an effective safety program. Staff meetings and tailgates should bedesigned to promote two-way communication between supervisors and employeesconcerning safety issues. Safety Recommendation Forms can be completed andsubmitted anonymously if desired.  The IIPP Manual is designed to communicateglobal safety information to employees, and should be located in a place thatis accessible to all employees. It includes safety information as well as theIIPP, SOPs and JSAs for hazardous activities, and information on hazardous chemicalsused in the work environment including a copy of the MSDS. Departmentalnewsletters and safety bulletin boards are other ways safety information iscommunicated. 

Compliance

A safety program isuseless if no one pays attention to it. Supervisors must set positive examplesfor working safely and require safe work practices from their staff.  Ifemployees do not follow safe working practices, it must be brought to theirattention and appropriate safety training provided to them. If they then failto follow safe work practices, supervisors must follow the University’sDisciplinary Process and any applicable union contract agreements to disciplineemployees.

Discussion Points:

·        Whatis the purpose of an accident investigation?

·        Whatare the basic questions you must answer during an accident investigation?

·        Whatsafety training is required before working with a hazardous chemical?

·        Ifyou do not know how to safely perform a job when asked to do it, what shouldyou do?

·        Whatare the methods used in your department to communicate safety information?

·        Whathappens if an employee repeatedly performs a task in an unsafe manner afterbeing provided with appropriate training and PPE?  

THIS PAGEINTENTIONALLY LEFT BLANK.

Effective dissemination of safetyinformation is an integral part of the Illness and Injury Prevention Program. This document was created to facilitate worker safety training.  Training mustbe completed before the use of any tool or piece of equipment, exposure to anyhazardous conditions, and/or when new hazards are identified. 

Be Prepared

Fire safety is everyone’s responsibility.Fire safety training is required annually to prepare all employees for a fireemergency.  The following measures can help to be better prepared to handle afire:

·        Knowthe exit routes from your office, floor, and building. Study these in advance.It is easy to become disoriented during an actual emergency.

·        Knowthe locations of fire extinguishers and know how to use them via the PASSmethod. Take the time to read the instructions. Report any missingextinguishers immediately.

·        Makesure that emergency numbers are posted on your telephone. Include your roomnumber.

·        Reportany unsafe conditions to the EH&S Fire Division immediately (x59797).  

DiscussionTopic:  Whathas your workplace done in preparation for a fire?

Fire Do’s and Don’ts

Most fires start out small, but after a fewminutes they can be out of control. It's important to act fast to sound thealarm and just as important to know what to do and to do it fast. Here are afew do’s and don’ts that will help you stay safe during a fire:

·        DO: Close all doors.This will slow the spread of fire and smoke. Activate the nearest fire alarmpull station.

·        DO: Report the fire;don’t assume someone else will do it. Call the campus police at 911 or310-825-1491 from a cell phone. 

·        DO: Use stairs tovacate the building. Assemble outside.

·        DON’T: Use an elevator.Elevators can be very dangerous in a fire, even when they appear to be safe. Neveruse elevators to exit!

·        DON’T:Arbitrarilybreak windows. Falling glass is a serious threat to pedestrians and firefighters or rescue personnel below.

·        DON’T: Exit until you havefelt the top of exit door. If the door is hot, or if excessive smoke preventsyour exit, keep the door closed.

·        DON’T: Go back for yourpersonal belongings if ordered to leave the building.

Types of Fires and Extinguishers

Fire extinguishers can be classified intofour classes depending on the type of fire they extinguish. 

       ClassA-(ASH) Ordinary combustibles fires such as paper, rags, wood

       ClassB-(BOIL) Flammable liquid fires such as oil, solvents, gasoline, grease

       ClassC-(CHARGE) Electrical fires

       ClassD-Combustible metals

Here are the most common types of fireextinguishers:

Pressurized waterextinguisher - Useonly on Class A fires. Do not use on Class B or C fires. (This could cause firespread or electrical shock.)

Carbon Dioxide - Use on Class B or Cfires

Dry chemical/Combination A,B,C- Use on Class A,Class B, and Class C fires. 

DiscussionTopic:  Whattypes of fire extinguishers are used in your workplace?

How to use a Fire Extinguisher

If a fire extinguisher is used, remember the “PASS”acronym:

Pull ring fromextinguisher handle.

Aim nozzle at base offire.

Squeeze Handle.

Sweep nozzle back andforth as you advance

Fire extinguisher training is available fromthe EH&S Fire Division (x59797). 

DiscussionTopic:  Doeseverybody know what PASS stands for? (Ask for the audience to reiterate it.)

Fire Prevention

·        Donot store items in corridors, aisles, exit routes, stairwells, fan rooms,equipment rooms, or electrical rooms.  Keep these areas clear.   

·        Tryto avoid using extension cords for various small appliances.  Do not useungrounded plugs or multiple outlet adapters.  These are not permitted and tendto overload electrical circuits, causing fires to occur.

·        Donot store materials in corridors, stairways, fan rooms, equipment rooms, andelectrical rooms. These areas must be kept clear at all times.

·        Alwayskeep fire rated doors closed. These doors are designed to slow the spread offire and protect egress routes.

·        Storeand handle chemicals and flammable liquids properly. Flammable liquids must bestored in limited quantities and be kept in approved flammable liquids storagecabinets.

DiscussionTopic:  Whatother fire prevention measures have been instituted in your workplace?

In the Event of a Fire

Use the nearest emergency shower or stop,drop, and roll! We all remember this second piece from elementary school whenthe firefighters came to visit.

DiscussionTopic:  Identifythe nearest emergency showers and practice stop, drop, and roll. 

See Also

·        FireExtinguisher Training through the EH&S Fire Division (x59797)

·        UCLAEmergency Management

Effective dissemination of safetyinformation is an integral part of the Illness and Injury Prevention Program(IIPP).  This document was created to facilitate worker safety training. Training must be completed before the use of any tool or piece equipment,exposure to any hazardous condition, or when new hazards are identified. 

Emergency Planning

Immediately after an emergency, essentialservices may be cut-off and local disaster relief and government responders maynot be able to reach you right away. One of the most important steps you cantake to prepare for emergencies is to develop a disaster plan.

Creating a Disaster/Evacuation Plan

·        Reviewthe UCLA Campus Evacuation Map with the employees.  Identify the evacuationareas for your department. 

·        Ifyou have one, review your departmental emergency response plan with theemployees.  If you don’t have one, develop a plan with your department. 

·        Discussand plan how your employees would stay in contact if you were separated.Identify two meeting places: the first should be near your building & thesecond should be away from building, in case you cannot return.

·        Draw,display, and discuss a floor plan of your building with all exits, hazards andevacuation routes.

·        Discussa plan for evacuating people with special needs or with disabilities. 

·        Ensureemployees know where emergency telephone numbers and emergency broadcaststations are posted (preferably by telephones).

·        Encourageemployees to take a first aid and CPR class.  (Class available through theDavid Geffen School of Medicine, Center for Pre-Hospital Care, 310-267-5959.)

·        Developa plan for shutting off electricity, gas and water supplies at main switchesand valves in your building. Have the tools you would need to do this (usuallyadjustable pipe and crescent wrenches).

Disaster Supply Kits

Review the items that your group might needin the event of an emergency (e.g., water, food, essential medication).  Makesure employees are aware of the resources and information on the UCLA EmergencyManagement website. 

If you have a disaster supply kit, review itscontents and update if necessary. 

Earthquake Safety Recommendation

There are actions youcan take before or even while an earthquake is happening, that will reduce yourchances of being hurt. Lights may be out or hallways, stairs, and room exitsmay become blocked by fallen furniture, ceiling tiles, and other debris.Planning for these situations will help you to take action quickly. Trainemployees in the following

·        Drop,cover, and hold; move only as far as necessary to reach a safe place.

·        Ifindoors, stay there until shaking stops. Many fatalities occur when people runoutside, only to killed by falling debris from collapsing walls and windows.

·        Ifoutdoors, find a spot away from buildings, trees, streetlights, power lines,and overpasses.

·        Ifin a vehicle, pull over at a clear location and stop

·        Makesure the group furniture and materials are seismically restrained. 

·        Securematerials stored on shelves.  

·        Storeheavy and breakable objects on low shelves.

·        Ifin a high-rise building, expect the fire alarms and sprinklers to go off duringan earthquake. Do not use the elevators.

·        Whatother preventive actions can you take to ensure the safety of yourself or yourcoworkers?

Resources:

UCLAEmergency Management Website- http://map.ais.ucla.edu/go/campus-safety

Effective dissemination of safetyinformation is an integral part of the Illness and Injury Prevention Program. This document was created to facilitate worker safety training.  Training mustbe completed before the use of any tool or piece of equipment, exposure to anyhazardous conditions, and/or when new hazards are identified. 

Introduction

Many lifting injuries can be prevented byreducing the weight and number of lifts as much as possible, and by learninghow to use appropriate lifting techniques when it is necessary to lift andcarry objects.

Use forklifts, hoists, carts, dollies, and othertypes of lifting equipment when you have to lift or move heavy or bulkyobjects.  If you must lift or move objects by hand, use of proper liftingtechniques can save you a great deal of pain and misery.  

Before lifting an object, assess the situationby asking yourself the following questions:

• Can you lift this load safely, or is it a two-person lift?

• How far will you have to carry the load?

• Is the path clear of clutter, cords, slippery areas, overhangs, stairs, curbs and uneven surfaces?

• Will you encounter closed doors that need to be opened?

• Once the load is lifted, will it block your view?

• Can the load be broken down into smaller parts?

• Would gloves improve your grip or protect your hands?

Size up the load

·        Testthe weight by lifting one of the corners. If it is too heavy or is shapeawkwardly, stop.

·        Considerasking for help from fellow workers, or break down the load into smallerparts. 

·        Tryto use a mechanical lift or a hand truck.

Discussion Topic:  What objects do youoften carry at your workplace? Can these objects be carried in a safer manner?

The Art of Lifting

There is really no“right way” to lift. However, there are more and less demanding ways to lift.The key to working safely is to figure out how to lift in the least demandingway possible when you have to move materials or tools. Here are some guidelinesto reduce your risk exposure when lifting:

Keep It Close andKeep the Curves!  Thecloser a load is kept to your power zone, the easier it is to keep the naturalcurves of your back. When the spine is in the natural curves, the vertebra,discs, ligaments and muscles are in their strongest and most supportiveposition. 

StaggeredStance: Liftingwith the feet close together and in line with each other makes it more difficultfor you to use your legs to help with the lift. Staggering your stanceencourages the legs to become involved and reduces the demands on your back.Simply stepping toward a load (with a staggered stance) moves the center ofgravity closer to the load and minimizes the demands of the lift. If you feelyour weight shifting forward onto your forward leg, you have successfullytransferred this weight demand from your back to your stronger legs. 

Builda Bridge: Inmost cases, the demands of any lift are determined by the position of thelifter’s upper body during the lift. Many people lift by bending over at thewaist, leaving their upper body hanging like a “one-sided bridge”. This placesall the demands of the lift onto the lower back. This load can be reduced by“building a bridge” to support the weight of the upper body. To do this, placean arm on your leg or a nearby stationary object. If you need both of your armsto manage the object your are lifting, step forward toward the load with oneleg and create a “bridge” with your legs to reduce the workload on your back.  

Feet First:  Moving your feetfirst gets you closer to the load and reduces the amount you have to reach. Thefarther you reach, the more you have to lift your upper body as well as theload. Moving your feet first also helps reduce the risk of twisting while youlift.

Discussion Topic:  Ask for volunteers todemonstrate the concepts of “Keep it Close and Keep the Curves”, “StaggeredStance”, “Build a Bridge”, and “Feet First”.

Prepare andCompensate:

Liftingand carrying loads can be hard work. Like athletes, workers can avoid injuriesor discomfort by preparing the body for work. Muscles generate more force whenwarm and full of oxygen. Stretching and moving around prior to work helps pumpblood into your muscles. Blood warms up muscles and brings in oxygen, allowingyour muscles “to breathe”. This can be particularly effective at the beginningof the workday and after breaks.

Compensating for work demandssimply means letting the body recover from work in an efficient manner.Performing periodic stretches can minimize accumulation of fatigue throughoutthe day. Stretches can “apologize” to the body for working it so hard. 

Discussion

• Do you prepare and compensate before and after lifting and carrying heavy loads?  Demonstrate some simple stretches that can help the employees prepare and compensate before and after a lift.

Use MechanicalLifting Devices Whenever Possible

The best way to avoida back injury is to reduce the number of lifts you have to do as much aspossible. Hand trucks, pushcarts and forklifts are great engineering controlsthat reduce your exposure to lifting hazards. If you use a forklift, make sureyou have training and are authorized to operate one.

Using hand trucks and pushcarts

• Push rather than pull.  It is easier and safer to push than to pull.  You can use your body weight to assist when pushing.
• Use powered carts when available.
• Keep close and lock your arms.  Stay close to the load, try not to lean over and keep the curves of your back when pushing or pulling. 
• Use both hands.  Carts are easier to push and control using both hands.
• Use tie-downs, if necessary, to secure the load.

Discussion

• What devices are available to you in your workplace to reduce your exposure to lifting hazards? Are these devices enough or is there a need for additional devices?

THIS PAGEINTENTIONALLY LEFT BLANK.

Effective dissemination of safetyinformation is an integral part of your Injury and Illness Prevention Program. This document was created to facilitate worker safety training.  Training mustbe completed before the use of any tool or piece equipment, exposure to anyhazardous condition, or when new hazards are identified. 

Introduction

Many chemicals usedin campus shops are considered hazardous. All employees who work with thesematerials must understand the health hazards involved and how to protectthemselves.  Cal-OSHA regulations require employers to communicate the hazardsof these chemicals to employees through the use of chemical labels and materialdata safety sheets (MSDS).

Physical& Health Hazards

Hazardous chemicalspose a physical or health danger. Chemicals are classified as being physicallyhazardous when they are flammable, combustible, corrosive, or reactive. Chemicals presenting health hazards include carcinogens, toxics, irritants, andsensitizers. The health effects of chemicals can be either acute (short-term),or chronic (long-term).  Acute effects can show upimmediately or soon after the exposure. Chronic effects may take years to showup.

Chemicalsubstances can take a variety of forms. They can be in the form of solids,liquids, dusts, vapors, gases, fibers, mists, and fumes. Solids and liquids areeasier to recognize since they can be seen. Fumes, vapors and gases are usuallyinvisible.  The form of a substance has a lot to do with how it gets into yourbody and what harm it can cause.

Chemicalsget into the body through three main routes of exposure: breathing(inhalation), skin or eye contact, or swallowing (ingestion). Once chemicalshave entered your body, some can move into your bloodstream and reach internal“target” organs, such as the lungs, liver, kidneys, or nervous system anddamage them.  

DiscussionTopics:

• What chemicals or chemical products are used in your work area?
• Where do you store your chemicals or chemical products?

• How can you identify the chemicals used in your department?

• What are some physical and health hazards associated with common chemicals in your workplace?
• How can chemicals enter the body?

MaterialSafety Data Sheets/Labels and Warnings

Warnings and labelson containers can provide basic safety information concerning the contents ofthe container. All containers must have labels. Material Safety Data Sheets(MSDSs) are data sheets that contain information about the health and safetyproperties of workplace chemical products. They are usually written by thesupplier or manufacturer of the product. All employees must have access toMSDSs for the chemicals they use.

An MSDS is requiredto have certain information. The form is divided into sections that provide adifferent type of information about the chemical product. These sections arenot always the same on every MSDS. Under Cal/OSHA’s Hazard Communicationstandard, an MSDS must contain the following information:

• Product identity and ingredients
• Physical and chemical characteristics
• Fire and explosion hazards
• Reactivity data
• Health hazards including symptoms, routes of exposure, and potential to cause cancer
• Legal exposure limits
• Precautions for safe handling and use
• Protective control measures
• Personal protective equipment
• Emergency and first aid procedures
• Spill and leak procedures

Exposure/ExposureLimits

When reading MaterialSafety Data Sheets (MSDS), you will frequently encounter abbreviations such asPEL, TWA, STEL, and IDLH. These abbreviations provide workers with importantinformation on how long they can be exposed to a chemical before harm mayoccur. The permissible exposure limit (PEL) is themaximum amount of a chemical a worker can be exposed to over an eight-hourperiod. The PEL is usually shown as a time-weighted average (TWA) to calculateexposure for an eight-hour workday and 40-hour work week. Short-term exposurelimit (STEL) is the amount of a chemical the worker should not be exposed toover a fifteen minute period. Immediately Dangerous to Life and Health (IDLH)means the chemical poses an immediate threat to your health.

Protection

The three acceptedstrategies for controlling exposure to hazardous materials are engineeringcontrols, administrative controls, and personal protective equipment (PPE).Engineering controls remove the hazard from the worker. An example of anengineering control is use of local exhaust ventilation or a fume hood. Administrative controls reduce worker exposure to hazardous materials. Examplesinclude work practice changes, such as working with small quantities ofchemicals or limiting exposure times. PPE is the least desirable control andshould be used as last resort. The use of PPE does not reduce or eliminate thehazard at the source, but it does protect the worker from exposure. Sometimes,PPE is the only solution available. 

DiscussionTopics:

• What are the two primary methods of communicating chemical hazards to employees? What labeling procedures do you use in your facility?
• Where are the MSDSs kept in your facility?
• What type of information can be found on an MSDS?
• What engineering and administrative controls are in place at your facility?
• Why is the information on the MSDS important?
• Who can employees ask for more information on any chemical they work with if they would like it?
• What job tasks in your workplace involve chemical use that could expose an individual to the permissible exposure limit?
• What type of PPE is required to work with chemicals in your facility?

Resources:

UC MSDS Website- http://www.actiocms.com/chemquik/mainpage.cfm

THIS PAGEINTENTIONALLY LEFT BLANK.

Effective dissemination of safetyinformation is an integral part of the Bruin Safety Program.  This document wascreated to facilitate worker safety training.  Training must be completedbefore the use of any tool or piece equipment, exposure to any hazardouscondition, or when new hazards are identified. 

Introduction

An effective toeliminate potential hazards in the workplace is by having good housekeepingpractices. Good housekeeping practices involve material movement and storagethroughout your entire workplace. It also includes a material flow plan toensure minimal handling. Employee training is the key component that willensure good housekeeping practices. Employees should be encouraged to reportany unusual hazards or conditions to their supervisor. Lastly, Quarterlyworkplace inspections are an essential tool that is used to find, recognize,and mitigate hazards that arise in the workplace.

Point of Discussion

• Take this time to conduct an overall inspection of your area (shop, office, lab) and ask employees what items of housekeeping must be routinely checked.

Light Fixtures

All buildings need adequatelighting to eliminate eye strain. Light fixtures with non-working lighttubes need to be replaced. Storage areas that contain combustible materials shouldhave explosion proof light fixtures installed. Lighting must bedistributed evenly to eliminate shadows or dark spots in the workplace.

Point of Discussion

• Are there any light fixtures that are non-functional or can you find an area in your workplace that could use more lighting?

Floors

Keeping floors dryand clear of trash and debris will eliminate all slip, trip, and fallaccidents.  All spills should be cleaned up immediately. All sawdust, shavings,or clippings should be swept up or vacuumed once the cutting has ceased.  Areasthat cannot be cleaned continuously, such as entranceways, should haveanti-slip flooring. Replace flooring that has been worn, ripped, or damaged asthis poses a tripping hazard.  Portable power tools or hand tools should beremoved from the work area and placed in storage if they are not in use. All flooropenings must be guarded to prevent serious falls.

Point of Discussion

• Are your floors kept free of trash and debris?

Chemical SpillClean-up